Air travel should not pose significant problems for patients with well-controlled diabetes.
Pre-planning is important and discussion of the itinerary with the diabetic management team plays an important part in this preparation for travel. It is essential that the diabetic passenger carries adequate equipment and medication in their hand baggage. It is important that insulin is not packed in the hold baggage even if it is not being used during the flight as insulin in the hold may be exposed to temperatures that could degrade it and there is the potential risk of loss of baggage en-route. Insulin may be satisfactorily carried in a cool bag for even the longest sector. Individual regimes should be discussed with the diabetic management team, but some general guidelines may be helpful.
When travelling east the day will be shortened and if more than two hours are lost, it may be necessary to take fewer units with intermediate or long-acting insulin.
When travelling west the travel day will be extended and if this is more than 2 hours it may be necessary to supplement this with additional injections of short-acting insulin or an increased dose of an intermediate-acting insulin.
Type 2 diabetes is not a problem on diet or oral medication, nor indeed on insulin as the endogenous insulin, which remains in Type 2 diabetes will provide a suitable buffer and assist control.
Further information on diabetes and travel is available from Diabetes UK.
Patients who use insulin pumps should also be aware of the potential impact of changes in the cabin air pressure on insulin delivery. The reduction in ambient pressure on ascent may lead to a slight increase in delivery of insulin as a result of the formation / expansion of air bubbles, which may be sufficient to cause symptomatic hypoglycaemia. A more severe impact could be seen in the (rare) event of sudden decompression of the cabin at altitude. A slight reduction in insulin delivery is also possible during descent.